Neurology
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Supratentorial intracerebral hematomas often are evacuated in rapidly deteriorating patients. Surgery may prevent death but not necessarily disability. The authors studied the outcome of emergent clot evacuation in patients with worsening massive intracerebral hemorrhage. ⋯ Craniotomy for rapidly worsening patients with supratentorial intracerebral hemorrhage and radiologic signs of brain tissue shift may result in functional independence in approximately a quarter of patients. However, all comatose patients who lost upper brainstem reflexes and had extensor posturing died despite surgery.
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Randomized Controlled Trial Clinical Trial
Safety, tolerability, and efficacy of orally administered cannabinoids in MS.
The authors conducted a randomized, double-blind, placebo-controlled, twofold crossover study in 16 patients with MS who presented with severe spasticity to investigate safety, tolerability, and efficacy of oral Delta(9)-Tetrahydrocannabinol (THC) and Cannabis sativa plant extract. Both drugs were safe, but adverse events were more common with plant-extract treatment. Compared with placebo, neither THC nor plant-extract treatment reduced spasticity. Both THC and plant-extract treatment worsened the participant's global impression.
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Clinical Trial
Acute migraine headache: possible sensitization of neurons in the spinal trigeminal nucleus?
To investigate trigeminal sensory processing in patients with migraine using a novel "nociception-specific" blink reflex. ⋯ The data suggest temporary sensitization of central trigeminal neurons during acute migraine attacks.